HISTORY

Drs. Véronique (DGV) and Lucien Dossou-Gbete (DGL) practice medicine in Benin (Cotonou and Porto-Novo, respectively) since January 1994, allowing them to give the following insights on health care in Porto Novo:

 Before there was is no one structure permitting a complete diagnostic process in one locale. Patients often abandon any attempt to receive treatment in the face of such difficulties as having to travel to the four corners of the city for additional exams or to consult with different organ specialists. The ever-growing length of the city and lack of transportation are just some of many reasons requiring comprehensive and efficient treatment in a single facility.

 It is difficult to properly treat a case, either in the course of everyday practice or in emergency situations, due to the lack of skilled health care workers. · We have been surprised by the overall poorness of health care given to patients in Benin, often a result of the multitude of "diagosticians" and "prescribers" who are not necessarily trained doctors.

 Before, when practicing from our office, we were forced to spend a great deal of time and energy convincing patients to agree to hospitalization. This was due to the lack of trust in the unreliable and unpredictable methods of hospitals and private clinics alike.

 Dr. DGL’s patients asked rather if they could not be "hospitalized" in beds in Dr. DGL’s office. It should be pointed out that people in Benin do not differentiate between clinics and doctor’s offices.

 We have often been frustrated by our lack of hospital beds for the purpose of clinical research. Indeed, research subjects are numerous; given the reality of local health care, it is all the more important to conduct this research in order to better treat patient cases.

 The absence of intensive care facilities often result in otherwise avoidable deaths.

We began to address the problem in 1996 by installing daytime hospital beds. This move was welcomed by our patients, who viewed it as a conventional hospital facility. The constant occupation of these two beds was confirmation of the need of such a structure. The beds allowed Dr. DGL, along with another doctor, to observe and treat patients everyday from 8 a.m. to 10 p.m. The idea for a multi-functional clinic eventually came to light; the clinic became operational in June 1998.

LOCATION

The clinic is located in Porto Novo. This city is the political capital of Benin and seat of the geographical department of Ouémé. Porto Novo covers a surface of 4,700 km2 for a population of 711,817. In 1998, life expectancy at birth was 56,5 years. The number of doctors, all fields combined, is estimated to be 50, seven of which are exclusively in private practice. Of the three existing clinics, only one has beds available for hospitalization.

TARGET

This clinic was constructed in order to meet the needs of AIDS victims in Porto Novo and the surrounding areas. Clinique Louis Pasteur receives patients from Porto Novo, Ouando, Missereté, Akron, Dangbo, Avrankou, Djrégbé, and Sakété, as well as the border zone in Nigeria.

Many of the patients are merchants, tertiary sector workers, and rural inhabitants. The majority of these people belong to depressed socio-economic groups.

OBJECTIVES

Our objectives are to give quality care to patients, promote AIDS prevention, conduct clinical research, advance health care education, train nurse aides, and provide a multi-functional facility congregating the skills and training necessary for meeting the area’s health care needs. The global aim is the development of local health care in general within the framework of DDS-Ouémé and the Department of Health guidelines.

Clinique Louis Pasteur is open to all practitioners respecting the medical professional code of ethics. Once approved by DGL, these practitioners may use the clinic’s facilities for treating their patients.

Diagnostic and treatment mission

Health care at the clinic covers general medicine, medical specialties, gynecology, obstetrics, emergency care, critical care, and surgery. The clinic is presently equipped to provide conventional radiography (simple x-ray, IVU, hysterography, barium enema, UGI barium study), ultrasound, medical biology, EKG, digestive surgery, gynecologic and obstetric surgery. We have treated cases ranging from malaria, meningitis, congestive heart failure, appendicitis, hernias, to cesarians.

Research mission

The goal of clinical research is to improve the management of patient cases in the face of the impoverished living conditions and financial resources of Benin citizens. A study has been conducted by several Porto Novo pharmacies evaluating the use of anti-malarial drugs. This study was the subject of an article in the international scientific journal Médecine et Maladies Infectieuses. Clinique Louis Pasteur was selected by PROLIPO, the Programme de Lutte Intégrée contre le Paludisme dans l’Ouémé (Program for the Fight Against Malaria in Ouémé) to participate in the evaluation of laboratory examinations used to diagnose malaria, as well as the monitoring of mortality rate in children under five, using the preceding birth technique (PBT).

Educational mission

Continuous hands-on and theoretical training is given to clinic personnel. Technical training workshops will eventually be made available to the staff of other health care facilities in the area. A school providing a 3-year nursing aide program presently turns out two to three nurse aides a year. Scientific meetings will be organized for doctors, midwives, nurses, and nurse aides. The CLP receives students from the Besançon School of Medicine, which has accredited the program as field training. At present, several french students have spent two months at the CLP in this capacity.

Health education classes are given at the clinic for women from Djassin township in an effort to increase awareness for prenatal monitoring. Classes on the prevention of transmissable diseases are also given at Béhanzin High School and the Rosette Educational Complex.